Best writers. Best papers. Let professionals take care of your academic papers

Order a similar paper and get 15% discount on your first order with us
Use the following coupon "FIRST15"
ORDER NOW

Cardiac Case Study: Impaired Coronary Perfusion and Chest Pain Kandice Sheridan is a 49-year-old female in the emergency department for “achiness” in the elbows that is atypical and worsening over the last three days. She states that the feeling awakens her at night. Ms. Sheridan has felt more short of breath with activity lately and has been under a lot of stress at work. She is planning a trip overseas in a few days and wants to confirm there is nothing significantly wrong before leaving the country

[ad_1]

Cardiac Case Study:  Impaired Coronary Perfusion and Chest PainKandice Sheridan is a 49-year-old female in the emergency department for “achiness” in the elbows that is atypical and worsening over the last three days. She states that the feeling awakens her at night. Ms. Sheridan has felt more short of breath with activity lately and has been under a lot of stress at work. She is planning a trip overseas in a few days and wants to confirm there is nothing significantly wrong before leaving the country. QUESTION #1 (5 Points)The nurse is beginning the initial assessment. In what priority order should these actions be performed?NURSING ACTIONSORDER OF PRIORITYPlace in Hospital Gown#1:Health History and medication use#2:Assessment of contributing symptoms#3:PQRST pain assessment#4:Vital sign assessment#5 QUESTION #2 (3 Points)The Emergency Room nurse documents the following admission note:·             49-year-old female admitted with atypical pain in the elbows. Afebrile, RR 18, HR 88, BP 145/88 (107), SpO2 97% on room air (RA). Denies chest pain and shortness of breath at this time. Says her arms feel “heavy” and elbows feel “achy.” Describes achiness as “less than during the night last night.” Denies nausea or other discomforts. Skin moist to touch. History includes iron deficiency anemia, C-sections x 2, and appendectomy. Family history consists of a father with an acute myocardial infarction (AMI) at age 56.List the Top 3 Priority assessment findingsAssessment #1: Assessment #2: Assessment #3:  QUESTION #3 (2 Points)Review the following prescriptions (orders) for this patient. Sept 10730Serum labs: complete blood cell count (CBC), comprehensive metabolic panel (CMP), prothrombin time (PT) and international normalized ratio (INR), partial thromboplastin time (PTT), lipid panel, troponin, myoglobin, creatine kinase-muscle/brain (CK-MB)12-lead electrocardiogram (EKG)Chest x-ray ASAPIV capped lineOxygen 2 L/NC for SpO2 < 95Which action should the nurse take first?A.       Request serum lab drawB.       Obtain 12-lead EKGC.       Place IV capped lineD.       Apply O2 at 2L NCQUESTION #4 (2 Points)            In preparation for the IV insertion, the nurse should place what size gauge capped IV line? __________   gauge QUESTION #5 (5 Points)The nurse reviews the following the 12-lead EKG for this patient. Which observation(s) does the nurse make (Select All That Apply)?A.       The patient has tachycardiaB.       There is ST segment elevation in the V leadsC.       There are premature ventricular contractions (PVCs) presentD.       There is artifact on the tracingE.        This EKG tracing is normalQUESTION #6 (2 Points)After reviewing the EKG, what should be the nurse’s next action?A.       Apply continuous EKG monitoringB.       Check to see if the serum lab report is backC.       Notify the healthcare provider of the EKG resultsD.       Apply the ordered oxygenQUESTION #7 (3 Points)The nurse reviews the following patient’s lab results. List the Top 3 Priority Lab findingsLab #1: Lab #2: Lab #3:  QUESTION #8 (8 Points – 2 points/section)The nurse gathers the lab report and begins to prepare an SBAR conversation for the health care provider (HCP). Complete each section of the communication form accordingly.S B A R  QUESTION #9 (5 Points) The nurse obtains several STAT verbal prescriptions from the HCP for a patient experiencing an acute myocardial infarction. In what order should the nurse complete these actions?NURSING ACTIONSORDER OF PRIORITYNitroglycerin (NTG) 0.4mg SL x 3 PRN chest pain#1:Consult Dr. Nemus, Cardiologist#2:Obtain blood pressure and heart rate#3:Read back the verbal orders#4:Morphine 2-4 mg IV PRN for pain unrelieved by NTG#5  CASE STUDY PROGRESSIONKandice was transferred to the cardiac cath lab for evaluation and now the cardiac cath lab RN is handing off report to the unit nurse with the following report:Kandice Sheridan is a 49-year-old returning from the cardiac cath lab after an anterior wall ST-Elevation Myocardial Infarction (STEMI). The cardiologist was able to place a stent in her proximal left anterior descending (LAD) artery. She also has a 40% lesion in her circumflex and a 30% lesion in her right coronary artery (RCA) which do not require intervention at this time. She has a sheath in her right femoral artery. There is no bleeding at the groin site, and her pedal pulses are 3-4+ bilaterally. Her skin is warm to touch. Her vital signs are stable.QUESTION #10 (4 Points)  The patient returns from a cardiac catheterization procedure with a right groin sheath in place. What should the nurse include in the priority assessment of this patient? Select all that apply.A.       Blood pressureB.       TemperatureC.       Right groin assessmentD.       Lung soundsE.        Cardiac monitorQUESTION #11 (2 Points)  The nurse reviews an order to begin a heparin continuous infusion for this patient.  The order reads:Maintain heparin infusion at 1,000 units/hr until 2100.  Pharmacy provides heparin 25,000 units in 500mL NS.  At what rate would the nurse program the infusion pump?________________mL/hrQUESTION #12 (2 Points)  The nurse obtains the following first three sets of vital signs.What should the nurse do next?A.       Have the unlicensed assistive personal complete the remaining set of vital signs.B.       Assess for bleeding at the sheath site.C.       Re-evaluate the vital signs in 15 minutes.D.       Notify the health care provider of the patient’s statusQUESTION #13 (2 Points)  Kandice asks what she can do to help decrease the risk for having another heart attack in the future. What should the nurse instruct? Select all that apply.A.       Eat a diet low in cholesterol and saturated fats.B.       Minimize carbohydrate intake.C.       Walk 30 minutes 5 days a week.D.       Increase dietary intake of fruit.E.        Monitor serum lipid levels QUESTION #14 (3 Points)        Evaluate the care of this patient.  Choose the Top 3 Priority discharge needs. List the Top 3 Priority discharge needs for this patient#1 #2: #3: QUESTION #15 (2 Points)   Kandice returns to the office two weeks later appearing withdrawn and sad. The nurse asks how things are going and she states, “It’s such an adjustment, I don’t know if I can do it.” What suggestions should the nurse make to the patient?A.       Request an antidepressant from the cardiologist.B.       Participate in a cardiac support group.C.       Encourage her spouse to be more supportive.D.       Suggest she takes more time off of wor

[ad_2]

Source link

 

"Looking for a Similar Assignment? Get Expert Help at an Amazing Discount!"